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How Virtual Reality Can Help Treat Chronic Pain

US News & World Report - Health logo US News & World Report - Health 1/14/2019 Ruben Castaneda
Doctor With Digital Tablet Explaining Patient Using Virtual Reality Simulator At Hospital: Virtual reality may reduce the length of hospital stays for some patients. © (Getty Images) Virtual reality may reduce the length of hospital stays for some patients.

Hollie Davis was hurting following an April 2018 traffic accident that left her with a broken hand and torn gluteus maximus muscles and ligaments. Davis had been riding the back of the motorcycle her husband was operating when a passenger vehicle turned into them, she says. "I was basically black and blue and swollen from the waist down," Davis, 41, recalls.

Four months after the accident, Davis was still experiencing serious pain on her left side, where the vehicle had slammed into her. She suffered pain in her left knee, lower back and gluteal area. Sometimes the pain was sharp, sometimes throbbing. A doctor prescribed a muscle relaxant and a non-opioid painkiller; the medication's effects were modest. The physical therapist she'd been seeing as part of her recovery regimen asked Davis if she'd be willing to try virtual reality to help manage her pain. Sure, Davis responded.

A physical therapist placed Davis in a room, outfitted her with virtual reality goggles and turned off the lights. Davis was immersed in a VR program that showed three-dimensional images of how nerves worked in the human body. Other VR programs showed peaceful beach and mountain images and taught breathing and relaxation techniques. Davis adopted the techniques, which "helped me manage my pain and made it easier to do my physical therapy exercises," she says. "It's part of a bigger (rehabilitative) picture." Today, "I'm doing pretty good. There's still some up and down days, but things are progressing in a positive direction," she says.

Spurred by research that suggests VR can help alleviate the anxiety and pain of patients suffering from acute and chronic pain, and the fact that the technology is becoming more affordable, a growing number of health care providers are using virtual reality to ease physical suffering. More than 250 hospitals nationwide use VR from AppliedVR, a Los Angeles-based company, says Matthew Stoudt, chief executive officer of the company.

Virtual reality – which puts viewers in an immersive, multi-sensory three-dimensional environment – can effectively distract patients from pain, studies suggest. For instance, research published in 2017 in the Journal of Medical Internet Research concluded that the use of VR in hospitalized patients "significantly reduces pain" compared to a two-dimensional video. A separate study, published in 2016 in the journal PLOS One, found that a five-minute virtual reality experience decreased the sensation of chronic pain by an average of 33 percent from pre-session to post-session. The study involved 30 participants who suffered from an array of chronic pain disorders, including cervical spine pain, lumbar spine pain, hip pain and abdominal pain.

If you're suffering from acute or chronic pain, here are the potential benefits of using virtual reality:

  • Better pain management.
  • A reduced need for painkillers.
  • Cost savings.
  • Learn healthy new skills.
  • Improved movement.

1. Better pain management.

Research suggests that VR can alleviate acute pain from burns, wounds, childbirth, dental procedures and brief surgeries, says David R. Patterson, a professor of psychology in the Department of Rehabilitation Medicine at the University of Washington School of Medicine in Seattle. VR has been helpful in reducing pain and calming patients in the emergency department at Inova Mount Vernon Hospital in Alexandria, Virginia, says Courtney Elliott, a registered nurse and clinical director of the emergency department. Inova has been using VR in the emergency department for two years. Initially, Elliott says, she was skeptical about its utility, but she quickly became a believer. She recalls a 9-year-old boy who came into the emergency department suffering from a broken arm after falling off a set of monkey bars. The child was tearing up and trying hard not to cry in front of his father. The boy was provided a VR headset with a relaxation program that showed dolphins swimming underwater. "He was so focused on the visualization we were able to put him in a splint in no time," Elliott says. "He kept saying, 'I see the dolphins.' He got through it without crying." The emergency department has used VR to help patients between the ages of 3 and 96, she says.

2. A reduced need for painkillers.

VR isn't a silver bullet for pain, but for some patients it can be effective enough to eliminate or mitigate the need to use painkillers, including potentially addictive opioids. "If you can capture enough of the brain's attention, there's that many fewer neurons (in the brain) to process pain," Patterson says. VR has helped some patients at Inova to the point that they need fewer painkillers, Elliott says. For example, some patients who have used VR to learn breathing and mindfulness techniques have needed less medication, Elliott says. And some patients who use VR don't need any medication. "It's very immersive," she says. "It aids the distraction and perception of reduced pain and therefore, (provides) increased comfort."

3. Cost savings.

Using VR can not only help curtail the use of opioids and other prescription medications, which saves money, it can also reduce the length of hospital stays for some patients, says Josh Sackman, president of AppliedVR. Unmanaged pain is one of the most common reasons for delayed discharge, so any safe yet effective non-pharmacologic method, including VR, to help a patient control his or her pain can result in reduced length of stay, translating to savings of hundreds or even thousands of dollars. "Anxiety and pain are so highly connected. By better managing anxiety before a procedure and using non-pharmacological tools to aid in post-operative recovery, patients have the potential to really improve the recovery process," Sackman says. Some virtual reality programs, like the one Davis watched that showed how nerves work in the body, educate patients about pain, says Adriaan Louw, a physical therapist and director of the Therapeutic Neuroscience Research Group, an independent collaborative initiative that studies pain neuroscience. It would be time-consuming and expensive for physicians to use part of their time to educate patients on how pain works, Louw says. "VR has the capacity to allow for scalability of pain education at a fraction of the cost, provide a standardized educational message, yet through immersion allow for a more individualized experience compared to patient books and websites," Louw says.

4. Learn healthy new skills.

Many times, it's not about resolving someone's pain, but about learning new skills to cope with that discomfort on a day-to-day basis, Stoudt says. Yet learning new skills can be difficult, particularly when you're facing a health challenge. Virtual reality is a useful tool that can accelerate learning and enhance retention through cognitive engagement, Stoudt says. You can learn new techniques like breathing and meditation that can help you deal with your health issue in the moment, while also providing you skills that you can use for the rest of your life, Stoudt says. "For example, you can literally visualize your breathing in VR and see the impact that your breath has on your body or on the world around you," he says. "Through this biofeedback, you can connect your mind to your body in ways never before possible and use that biodata to ensure you are 'doing it right.' This can positively reinforce your new skills."

5. Improved movement.

For some chronic pain patients, like Davis, learning breathing and meditation techniques can help manage symptoms, which in turn allows more physical activity. Greater levels of physical activity generally promote healing, says Larry Benz, a physical therapist based in Louisville, Kentucky. "Chronic pain patients can't rest," Benz says. "We have to get them moving. Movement helps lubricate joints and keeps them working properly; it promotes improved circulation and better range of motion. Physical activity helps your heart and lungs function. Movement activates your body's natural healing properties."

Related Video: Study Says Opioids May Not Help Those With Chronic Pain (Provided by Newsy)



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